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A client at 37 weeks' gestation has been advised that she is positive for group B streptococcus (GBS). Which of the following comments by the nurse is appropriate at this time?

A.

The doctor will prescribe intravenous antibiotics for you.

B.

A visiting nurse will administer them to you in your home.

C.

You are at very high risk for an intrauterine infection.

D.

It is important for you to check your temperature every day.

E.

The bacteria are living in your vagina.

Answer and Explanation

The Correct Answer is C

Choice A rationale

While intravenous antibiotics are given during labor to prevent GBS transmission to the baby, it is not administered at home but in the hospital when labor begins.

 

Choice B rationale

GBS does not significantly increase the risk of intrauterine infection that requires daily temperature checks; it primarily poses a risk of neonatal infection during delivery.

 

Choice C rationale

GBS bacteria reside in the vagina and can be transmitted to the baby during delivery. Administering antibiotics during labor helps protect the baby from serious GBS-related illnesses.

 

Choice D rationale

GBS does not cause scarlet fever or the symptoms described; those are caused by different bacteria, namely Streptococcus pyogenes. .


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Correct Answer is B

Explanation

Choice A rationale

While massaging the fundus and ensuring IV access are correct initial actions, methylergonovine (Methergine) is typically used for patients without hypertensive history due to its

potential to raise blood pressure.

Choice B rationale

This option correctly identifies initial steps and appropriate medication. Carboprost-tromethamine (Hemabate) is effective in controlling postpartum hemorrhage and can be safely

used in patients with hypertension when oxytocin is insufficient.

Choice C rationale

Quantifying blood loss is essential but it is not an immediate priority when the patient is showing signs of significant bleeding and instability. Immediate intervention to control bleeding

takes precedence.

Choice D rationale

Assisting the patient to the restroom and then massaging the fundus overlooks the immediate need to control bleeding. This approach may delay necessary treatment and increase

the risk of further hemorrhage.

Choice E rationale

Straight catheterization and oxytocin maintenance are part of the management of postpartum hemorrhage but do not address the immediate need to ensure uterine contraction and

control active bleeding as effectively as the initial steps outlined in Choice B. .

Correct Answer is B

Explanation

Choice A rationale

Swaddling provides warmth but doesn't address jitteriness, which may be due to hypoglycemia.

Choice B rationale

Jitteriness in a newborn can indicate hypoglycemia. Prompt glucose assessment is crucial for early detection and management.

Choice C rationale

Feeding could help with glucose levels, but without knowing the glucose status, it might not be the immediate priority.

Choice D rationale

Routine medications are important but not as urgent as addressing possible hypoglycemia in a jittery baby.

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